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Nurse Practitioners

Diagnose and treat acute, episodic, or chronic illness, independently or as part of a healthcare team. May focus on health promotion and disease prevention. May order, perform, or interpret diagnostic tests such as lab work and x rays. May prescribe medication. Must be registered nurses who have specialized graduate education.

Source: O*Net Online


What do Nurse Practitioners do?

  • Advocate for accessible health care that minimizes environmental health risks.
  • Analyze and interpret patients' histories, symptoms, physical findings, or diagnostic information to develop appropriate diagnoses.
  • Consult with or refer patients to appropriate specialists when conditions exceed the scope of practice or expertise.
  • Counsel patients about drug regimens and possible side effects or interactions with other substances such as food supplements, over-the-counter (OTC) medications, and herbal remedies.
  • Detect and respond to adverse drug reactions, with special attention to vulnerable populations such as infants, children, pregnant and lactating women, and older adults.
  • Develop treatment plans based on scientific rationale, standards of care, and professional practice guidelines.
  • Diagnose or treat acute health care problems such as illnesses, infections, and injuries.
  • Diagnose or treat chronic health care problems such as high blood pressure and diabetes.
  • Diagnose or treat complex, unstable, comorbid, episodic, or emergency conditions in collaboration with other health care providers as necessary.
  • Educate patients about self-management of acute or chronic illnesses, tailoring instructions to patients' individual circumstances.
  • Keep abreast of regulatory processes and payer systems such as Medicare, Medicaid, managed care, and private sources.
  • Maintain complete and detailed records of patients' health care plans and prognoses.
  • Maintain current knowledge of state legal regulations for nurse practitioner practice including reimbursement of services.
  • Maintain departmental policies and procedures in areas such as safety and infection control.
  • Order, perform, or interpret the results of diagnostic tests such as complete blood counts (CBCs), electrocardiograms (EKGs), and radiographs (x-rays).
  • Perform primary care procedures such as suturing, splinting, administering immunizations, taking cultures, and debriding wounds.
  • Perform routine or annual physical examinations.
  • Prescribe medication dosages, routes, and frequencies based on patients' characteristics such as age and gender.
  • Prescribe medications based on efficacy, safety, and cost as legally authorized.
  • Provide patients or caregivers with assistance in locating health care resources.
  • Provide patients with information needed to promote health, reduce risk factors, or prevent disease or disability.
  • Read current literature, talk with colleagues, and participate in professional organizations or conferences to keep abreast of developments in nursing.
  • Recommend diagnostic or therapeutic interventions with attention to safety, cost, invasiveness, simplicity, acceptability, adherence, and efficacy.
  • Recommend interventions to modify behavior associated with health risks.
  • Schedule follow-up visits to monitor patients or evaluate health or illness care.
  • Supervise or coordinate patient care or support staff activities.
  • Treat or refer patients for primary care conditions such as headaches, hypertension, urinary tract infections, upper respiratory infections, and dermatological conditions.

Source: Career OneStop


Work conditions

Most RNs work in well-lighted, comfortable health care facilities. Home health and public health nurses travel to patients' homes, schools, community centers, and other sites. RNs may spend considerable time walking and standing. Patients in hospitals and nursing care facilities require 24-hour care; consequently, nurses in these institutions may work nights, weekends, and holidays. RNs also may be on call?available to work on short notice. Nurses who work in office settings are more likely to work regular business hours. About 23 percent of RNs worked part time in 2006, and 7 percent held more than one job.

Nursing has its hazards, especially in hospitals, nursing care facilities, and clinics, where nurses may care for individuals with infectious diseases. RNs must observe rigid, standardized guidelines to guard against disease and other dangers, such as those posed by radiation, accidental needle sticks, chemicals used to sterilize instruments, and anesthetics. In addition, they are vulnerable to back injury when moving patients, shocks from electrical equipment, and hazards posed by compressed gases. RNs who work with critically ill patients also may suffer emotional strain from observing patient suffering and from close personal contact with patients' families.

Source: NIH LifeWorks


Education requirements

There are three major educational paths to registered nursing: A bachelor's of science degree in nursing (BSN), an associate degree in nursing (ADN), and a diploma. BSN programs, offered by colleges and universities, take about 4 years to complete. Generally, licensed graduates of any of the three types of educational programs qualify for entry-level positions as staff nurses. There are hundreds of registered nursing programs that result in an ADN or BSN; however, there are relatively few diploma programs.

Many RNs with an ADN or diploma later enter bachelor's programs to prepare for a broader scope of nursing practice. Often, they can find a staff nurse position and then take advantage of tuition reimbursement benefits to work toward a BSN by completing an RN-to-BSN program.

Accelerated BSN programs also are available for individuals who have a bachelor's or higher degree in another field and who are interested in moving into nursing.

Individuals considering nursing should carefully weigh the advantages and disadvantages of enrolling in a BSN program, because, if they do, their advancement opportunities usually are broader. In fact, some career paths are open only to nurses with a bachelor's or master's degree. A bachelor's degree often is necessary for administrative positions and is a prerequisite for admission to graduate nursing programs in research, consulting, and teaching, and all four advanced practice nursing specialties?clinical nurse specialists, nurse anesthetists, nurse midwives, and nurse practitioners. Individuals who complete a bachelor's receive more training in areas such as communication, leadership, and critical thinking, all of which are becoming more important as nursing care becomes more complex. Additionally, bachelor's degree programs offer more clinical experience in non-hospital settings.

All four advanced practice nursing specialties require at least a master's degree. Most programs last about 2 years and require a BSN degree and some programs require at least 1 to 2 years of clinical experience as an RN for admission.

All nursing education programs include classroom instruction and supervised clinical experience in hospitals and other health care facilities. Students take courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology and other behavioral sciences, and nursing. Coursework also includes the liberal arts for ADN and BSN students.

Supervised clinical experience is provided in hospital departments such as pediatrics, psychiatry, maternity, and surgery. A growing number of programs include clinical experience in nursing care facilities, public health departments, home health agencies, and ambulatory clinics.

Source: NIH LifeWorks


Licensing requirements

In all States and the District of Columbia, students must graduate from an approved nursing program and pass a national licensing examination, known as the NCLEX-RN, in order to obtain a nursing license. Nurses may be licensed in more than one State, either by examination or by the endorsement of a license issued by another State. Currently 20 States participate in the Nurse Licensure Compact Agreement, which allows nurses to practice in member States without recertifying. All States require periodic renewal of licenses, which may involve continuing education.

Source: NIH LifeWorks


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Stats for Nurse Practitioners in Hawaii

Statewide

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In Honolulu / Oahu

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In Hawaii County

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In Maui County

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In Kauai County

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State and county data sources:
hiwi.org (updated July 2012)
bls.gov (updated May 2011)